Impact of maternal nutritional supplementation in conjunction with a breastfeeding support program on breastfeeding performance, birth, and growth outcomes in a Vietnamese population

<p><b>Purpose:</b> This study aimed to evaluate the effects of maternal nutritional supplementation (MNS) in conjunction with a breastfeeding support program on birth outcomes and breastfeeding performance.</p> <p><b>Methods:</b> A total of 228 singleton Vietnamese mothers aged 20–35 years at 26–29 weeks of gestation with pre-pregnancy body mass index (BMI) < 25.0 kg/m² were randomized to the intervention (<i>n</i> = 114), receiving MNS (252 kcal/day) daily up to 12 weeks postpartum and four breastfeeding education and support sessions or to the control (<i>n</i> = 114), receiving standards of care.</p> <p><b>Results:</b> The intervention was 2.09 times more likely to exclusively breastfeed over the 12 weeks than the control (95%CI: 1.05–4.13, <i>p</i> = .0358), after controlling for potential confounders. Infant’s breast milk intake was significantly higher in the intervention than the control among mothers with baseline mid-upper arm circumference (MUAC) < 50th (<i>p</i> = .0251). Infants in the intervention had significantly higher birth weight (<i>p</i> = .0312), birth weight-for-age (<i>p</i> = .0141) and birth head circumference-for-age (<i>p</i> = .0487), and higher head circumference-for-age <i>z</i>-score (<i>p</i> = .0183) development over the postnatal period, compared with the control.</p> <p><b>Conclusions:</b> Use of MNS and breastfeeding support improve birth outcomes and exclusive breastfeeding (EBF) rate in Vietnamese mothers. Additionally, it promotes breast milk production among mothers with lower baseline MUAC.</p

Development scores from ASQ-3 and Bayley-III at 30 months of age by study groups.

<p>Development scores from ASQ-3 and Bayley-III at 30 months of age by study groups.</p

Results of Cox’s proportional hazards models (<i>HR</i>s, 95% CI) for discontinuing exclusive breastfeeding.

<p>Results of Cox’s proportional hazards models (<i>HR</i>s, 95% CI) for discontinuing exclusive breastfeeding.</p

Study flow chart.

<p>RCT, randomized controlled trial; BF, breastfed.</p

Odds Ratios (and 95% confidence intervals) of getting an above the median score of neurodevelopment at 30 months of age among children in the intervention group compared to the control.

<p>Odds Ratios (and 95% confidence intervals) of getting an above the median score of neurodevelopment at 30 months of age among children in the intervention group compared to the control.</p

Impact of maternal nutritional supplementation in conjunction with a breastfeeding support program during the last trimester to 12 weeks postpartum on breastfeeding practices and child development at 30 months old - Fig 2

<p>Kaplan-Meier survival curves for duration of (a) any breastfeeding duration and (b) exclusive breastfeeding by treatment. - - - - - Control, ^_________ Intervention, + Censored.</p

Maternal breastfeeding and child feeding practices.

<p>Maternal breastfeeding and child feeding practices.</p